Government Income Supplement Program

Customer Agreement

Please Print and complete this agreement, then fax or email it to:   admin@aid4families.com 

This basic form is for customer information only. aid4families.com does not request, sell, or distribute customer information. Most records of the customers file will be of transactions (deposits received & benefits paid) and will be distributed through email. Clients are encouraged to maintain their own records as well (bank wire confirmations, cancelled checks and payments received). In light of our respect for privacy policy, it remains the clients responsibility to make us aware of any changes in their personal status (change of address, etc.) Payments can only be made in the name of the depositor (no exceptions) ; for third party funding (such as an adult child of an elderly parent) , please purchase a teller check, money order, or if possible bank wire through the beneficiaries bank account. Client acknowledges that payments have not been taxed and reporting benefits is the sole responsibility of the client. Payments are distributed on the 1st Tuesday of each month. Renewals are available at the expiration of the current contract. Changes to the percentage received/saved will appear after your next payment. We reserve the right to amend policy at our discretion, except for contract principles (frequency of payments, 25%quarterly and contract length will not be changed under any circumstances) . Checks are mailed to mailing address on file, please allow 2 payments for changes to take effect. i.e. Give a permanent mailing address ; for ex. A student may give a parents address. If you move, have your mail forwarded as soon as possible or contact us with an alternate mailing address 60 days prior to the move. All new accounts must be funded no later than 14 days from receipt of the aid form. Failure to do so will result in contract default and you will not be permitted to resubmit another application for a period of one year. This offer is void where prohibited.

Name:_____________________                           Phone: _____________________

Email:_____________________                           2nd Number: ________________

Did a assistance rep.  refer you?  Name:________________________    Country:_________________

Mailing Address:

 ________________________            Deposit Amount: ________ USD ___ CAD ___

 ________________________            Save 25% ___   Save 100%___

 ________________________   Receive Payment 25%___Receive payment 10%___

 ________________________

Term _________ year/s                            Choose the combination in which you would prefer to save/receive your funds. 

                                                                       There is a 25% maximum.

Client/customer understands that you are not purchasing a registered financial instrument that is tradable with any other party and has no cash value.
A GISP is a certificate reflecting reception of your deposit and a 2-party contract giving aid4families the authority to act as a private party trustee of income benefits.
I attest, being of legal age and sound mind, that I enter into this agreement with funds accumulated only by legal means and affirm that use of these funds does not constitute financial hardship.

Sign or print your full legal name in the space provided.

________________________________________________________________________

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